Reschke MM, et al. - Given that general anaesthesia for caesarean delivery can be averted by rapid-onset epidural local anaesthesia, researchers examined 24 randomised controlled trials including 1,280 women, in this Bayesian network meta-analysis of direct and indirect comparisons to rank speed of onset of the six local anaesthetics most frequently used epidurally for surgical anaesthesia for caesarean delivery. The included studies were identified from Google Scholar, PubMed, EMBASE, Ovid, CINAHL and CENTRAL. The mean (95%CrI) onset following bupivacaine 0.5% was found to be 19.8 (17.3–22.4) min, vs which the mean (95%CrI) speed of onset following lidocaine 2% with bicarbonate, 2-chloroprocaine 3% and lidocaine 2% was 6.4 (3.3–9.6) min faster, 5.7 (3.0–8.3) min faster and 3.9 (1.8–6.0) min faster, respectively. The rate (95%CrI) of intraoperative hypotension was noted to be the least following l-bupivacaine 0.5%, 315 (236–407) per 1000, and highest following 2-chloroprocaine 3%, 516 (438–594) per 1000. Following ropivacaine 0.75% 48 (19–118) per 1000 and after 2-chloroprocaine 3%, 250 (112–569) per 1000, the rate (CrI) of intraoperative supplementation of analgesia was least and was the highest, respectively.